Psychosocial, cultural, and environmental predictors of tobacco use among Asian Americans in Maryland

Background: Few data exist that thoroughly examine smoking behaviors of Asian American (AA) subgroups in Maryland. Existing survey data on tobacco use among aggregated AAs in Maryland are too general and lack specificity.

Objective: To investigate cultural, psychosocial, and environmental factors influencing tobacco use among four major AA communities in Maryland.

Methods: Four focus groups (total of 43 participants) were conducted in Asian Indian, Chinese, Korean, and Vietnamese communities to collect qualitative data on cultural, psychosocial, and environmental factors that influence tobacco use behaviors. Recommendations for the development of community-specific smoking cessation programs were discussed. We used MAXQDA to code emergent themes and analyze data.

Results: Social smoking was described as an essential cultural component among all communities. There was a remarkable pattern of gender differences, where smoking among females was perceived to be a stigma. Military participation and war significantly influenced smoking behavior in Korean and Vietnamese communities. The knowledge and use of other tobacco products such as bidis and hookahs was more prevalent among Asian Indians and younger generations. In the Chinese community, respondents revealed the significance of cigarettes as a tradition and status symbol. In general, participants were unaware of available smoking cessation programs through the state or other providers. Most smokers in these communities did not seek external help for smoking cessation and preferred quitting independently.

Recommendations: Community- and faith-based organizations and other community specific media were recommended as ideal communication channels. Participants suggested future smoking cessation programs be more linguistically appropriate and culturally sensitive.